Cold Sores

Specific types of the herpes simplex virus (HSV) cause this condition. There is no cure for the virus, and once you’ve contracted it, you always have it in your system—though you may be asymptomatic. The virus spreads from direct contact with other people or objects.

Some of the known triggers for flare-ups include sun exposure, stress, fever, colds or other viral infections, allergies, fatigue, dental work, cosmetic surgery, injuries to the skin, immune system changes, certain foods, and hormonal changes that are related to menstruation.

Fever blisters occur in stages, and it may take days for symptoms to begin after someone is infected. Patients typically experience itching, burning, and tingling around the lips prior to blister formation. These small, raised, fluid-filled blisters usually erupt around the mouth or lips, or on the nose or cheeks, though they can affect any part of the face, depending on where the virus has entered the body.

Cold sores usually appear as a group of blisters. The skin beneath them becomes red, swollen, and painful. Eventually, the blisters flatten as the fluid is released. This oozing and crusting stage lasts for several days. Finally, the blisters crust over and the involved skin may be itchy. Untreated cold sores tend to heal within two weeks.

Patients may also have symptoms such as fever, muscle aches, sore throat, headache, red or swollen gums, and swollen lymph nodes with the first outbreak. These symptoms are greatly reduced or absent with subsequent episodes.

Anyone can get cold sores. Many adults carry the virus, even if outbreaks don’t ever occur. However, people with weakened immune systems due to certain chronic conditions or specific medical treatments stand a greater risk of developing severe complications. These immunocompromising conditions include HIV/AIDS, atopic dermatitis (eczema), cancer chemotherapy, and anti-rejection drugs for organ transplants

Topical creams can be purchased at a pharmacy to relieve the discomfort of cold sores and help them to heal more quickly. You can also apply ice or take over-the-counter anti-inflammatory medications, such as Ibuprofen, to ease the discomfort.

Although you can treat this condition on your own with at-home remedies, you should see a doctor if you have a weakened immune system, the cold sores aren’t healing after several weeks, symptoms have become severe, outbreaks are occurring frequently, or your eyelids or inside of your eyes are affected. Once a dermatologist has diagnosed cold sores, anti-viral medications and creams can be prescribed to reduce symptoms and the risk of future breakouts.

Aside from taking prophylactic anti-viral medications, you can prevent cold sores by avoiding behaviors or conditions that trigger them. Apply broad-spectrum SPF 50 sunscreen and use a lip balm that contains SPF all year round, get plenty of sleep to strengthen your immune system, avoid kissing or other forms of skin contact with others when you have cold sores, don’t share personal items, and keep your hands clean during an outbreak. Refrain from touching the site of an active flare.

The Bryn Mawr Skin & Cancer Institute team is experienced in diagnosing and addressing many dermatological conditions that cause bumps, sores, redness, itching, and discomfort. We treat general rashes, poison ivy, folliculitis, and hives. Our dermatologists are ready to identify the cause of your problem and help manage symptoms.